MEDICARE: DR. BARRY SCHIRACK O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	146L00000X	Paramedic	005552	GA
2	152W00000X	Optometrist	OPT1060	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285625780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY SCHIRACK O.D.

Provider Business Mailing Address
First Line	:	6790 HIGHWAY 92
Second Line	:	STE 100
City	:	ACWORTH
State	:	GA
Zip	:	30102-2591
Country	:	US
Telephone Number	:	770-924-3355
Fax Number	:	770-928-1205

Provider Business Practice Location Address
First Line	:	6790 HIGHWAY 92
Second Line	:	STE 100
City	:	ACWORTH
State	:	GA
Zip	:	30102-2591
Country	:	US
Telephone Number	:	770-924-3355
Fax Number	:	770-928-1205

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	04/16/2020

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